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Trauma Treatment for Children in War : build-up of an evidence-based large-scale Mental Health Intervention in North-Eastern Sri Lanka

Trauma Treatment for Children in War : build-up of an evidence-based large-scale Mental Health Intervention in North-Eastern Sri Lanka

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SCHAUER, Elisabeth, 2008. Trauma Treatment for Children in War : build-up of an evidence-based large-scale Mental Health Intervention in North-Eastern Sri Lanka

@phdthesis{Schauer2008Traum-10670, title={Trauma Treatment for Children in War : build-up of an evidence-based large-scale Mental Health Intervention in North-Eastern Sri Lanka}, year={2008}, author={Schauer, Elisabeth}, address={Konstanz}, school={Universität Konstanz} }

deposit-license Traumabehandlung für Kriegskinder. Der Aufbau eines evidenzbasierten Interventionsprojekts in Nord-Ost Sri Lanka. 2011-03-25T09:20:42Z application/pdf 2011-03-25T09:20:42Z North-Eastern Sri Lanka is ravaged by war since more than two decades. The civilian population, adults and children alike, has suffered uncounted traumatic events, such as areal bombing, shelling, torture, killings, persecution, forced migration and many other adverse life circumstances that usually accompany armed conflict. The focus of this work is on the build-up of a population-based mental health structure for the most severely affected children. Based on prior epidemiological studies that our working group has carried out in Vanni, Vallikamam and Jaffna educational zones (C. Catani, Schauer, Onyut et al., 2005; Elbert et al., in press), which showed high scores of PTSD, Depression and Suicidality among school-aged, war-affected children, we suggested a Cascade model of school-based psychological care to the Ministry of Education, Colombo and to the Education Council of Tamil Eelam. Based on this design, during the years 2002-2005 a large-scale implementation took place, whereby 150 teachers were trained as Master Counsellors and 1500 as Befrienders . A number of organisations and institutions worked together to make this happen: German Technical Cooperation (GTZ) Sri Lanka, Ministry of Education Basic Education Sector Program (Colombo & North-Eastern Provinces), Education Council of Tamil Eelam (Kilinochchi), Shantiham Centre for Health and Counselling (Jaffna), University of Jaffna and our Non-Governmental Organisation vivo .<br />This thesis describes the psychological and psychiatric consequences of war on children, especially the development of Post-Traumatic Stress Disorder (PTSD) and its comorbidity, discusses the relevance and current controversy around project level interventions in war and crisis regions around the world, looks at options for individual treatment of child PTSD, including a detailed description of Narrative Exposure Therapy for Children (KIDNET) and finally describes the build-up of the cascade model structure, training- and material development as well as its scientific evaluation on site.<br />As a highest-level evaluation component and to proof the efficacy of this school-based service structure, we undertook a randomised controlled cluster dissemination trial in the framework of the overall assessment of this project; the first of its kind among war-affected stayee children worldwide. 47 children who suffered from severe PTSD (mean CAPS trauma symptoms score 65.5) and who had experienced a mean number of six different types of traumatic events, were randomly enrolled to receive six manualised treatment sessions of either KIDNET, a trauma-focussed, short-term therapy with exposure elements (M. Schauer, Neuner, & Elbert, 2005; M Ruf et al., 2007), or MED, a locally designed meditation/relaxation protocol from within the culture . 14 of the prior trained Master Counsellors were randomly assigned to a treatment procedure and 3-4 child patients each. No dropout occurred, all children completed treatment.<br />Results show a highly significant reduction of CAPS trauma symptoms (F(1,38)=57.9; p Trauma Treatment for Children in War : build-up of an evidence-based large-scale Mental Health Intervention in North-Eastern Sri Lanka Schauer, Elisabeth eng 2008 Schauer, Elisabeth

Dateiabrufe seit 01.10.2014 (Informationen über die Zugriffsstatistik)

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